2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2014 Conference Abstracts

Timeliness of Chlamydia Laboratory and Provider 
Reports: A Modern Perspective
Patrick T. Lai*1, 3, Janae E. Johns2, Uzay Kirbiyik2, 3 and Brian E. Dixon2, 3

1Indiana University, School of Informatics and Computing, Indianapolis, IN, USA; 2Indiana University, Richard M. Fairbanks School of 
Public Health, Indianapolis, IN, USA; 3Regenstrief Institute, Center for Biomedical Informatics, Indianapolis, IN, USA

Objective
To analyze the time delay between a chlamydia positive test 

diagnosis and when a laboratory and/or a provider sends a report to a 
local public health department.

Introduction
Timeliness of reports sent by laboratories and providers is a 

continuous challenge for disease surveillance and management. Public 
health organizations often collect communicable disease reports with 
various degrees of timeliness raising the concern about the delay in 
patient information received (1). Timely reports are beneficial to 
accurately evaluate community health needs and investigate disease 
outbreaks (2). According to Indiana state law, chlamydia reports are 
required to be sent to public health within 3 days after a positive test 
result confirmation (3). Therefore, laboratories and providers must 
be accountable and comply with regulation to ensure accurate data 
quality of disease assessment.

Methods
A sample of 2,428 chlamydia laboratory and provider reports were 

collected during the period from May 2012 through July 2012 from a 
local health department serving the Indianapolis area. Due to absence 
of test confirmation dates, dates that a report is sent to public health, 
and other missing data, only 1,752 reports were included in this study. 
The time delay was calculated by determining the difference between 
when the initial report is sent to public health following positive 
confirmatory test by the laboratory. Reports were differentiated as 
either a laboratory report or a provider report coming directly from a 
clinician or a hospital setting. Statistical analyses and frequency tables 
were conducted using SAS 9.4.

Results
Table 1 displays the counts of chlamydia laboratory and provider 

reports according to the time delay in days, the percentage of reports 
sent to public health within 3 days, and the summary statistics for the 
two types of reports with a graphical representation shown in Figure 
1. There is a clear lag between a lab test and when a provider report is 
sent to public health. Negative binomial regression result was highly 
significant with p < 0.001.

Conclusions
This study shows the importance of continued examination of 

timeliness of disease reporting from both laboratory and provider 
settings. Most lab reports are received electronically and comply 
with state law. However, reports from providers tend to be fax-based 
and received later than the 72 hours desired by health officials. With 
the greater adoption of electronic health records (EHR), it might be 
possible to further enhance disease surveillance through more timely 
provider-based reporting which could also reduce the volume of 
missing data from provider reports like those observed with electronic 
lab reporting (2). Future research should examine EHR capacity and 
clinical workflows to improve provider-based reporting processes.

Figure 1 Frequency count and time delay of chlamydia reporting for laboratory 
and provider reports

Keywords
Public Health Reporting; Timeliness; Chlamydia; Data Quality; 
Communicable Disease Control

Acknowledgments

This project was supported by grant number R01HS020909 from the 
Agency for Healthcare Research and Quality. The content is solely the 
responsibility of the authors and does not necessarily represent the official 
views of AHRQ.

References

1) Overhage JM, Grannis S, McDonald CJ. A Comparison of the
Completeness and Timeliness of Automated Electronic Laboratory
Reporting and Spontaneous Reporting of Notifiable Conditions.
American Journal of Public Health. 2008 Feb;98(2):344-50.

2) Dixon BE, McGowan JJ, Grannis SJ. Electronic Laboratory Data
Quality and the Value of a Health Information Exchange to Support
Public Health Reporting Processes. AMIA Annu Symp Proc.
2011;322-30.

3) Indiana Administrative Code: Title 410 Indiana State Department of
Health. Indiana General Assembly. http://www.in.gov/legislative/iac/
iac_title?iact=410.

*Patrick T. Lai
E-mail: ptlai@imail.iu.edu    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e141, 201